Louisiana Treasurer John Kennedy is just both inside and outside of state government who are nonplussed over the current state of healthcare in Louisiana.

With much uncertainty regarding Medicaid payment for Louisiana healthcare services (until decisions are made by the Bobby Jindal administration and details provided by them, there are at least two major questions that confuses confounds Kennedy but perhaps many in Louisiana:

With the new Charity Hospital system in South Louisiana undergoing major reform announced this week by the Jindal administration, which will involve private management by Ochsner Health System and Touro Medical Center, and with Governor Jindal refusing to approve two provisions of the controversial Affordable Care Act or commonly known as “Obamacare”, how will Louisiana be able to pay for the hundreds of thousands of people currently under Medicaid or non-insured?

Without a certain flow of revenues coming in from the federal government under Obamacare, how will Louisiana pay for a new $1.2 billion Charity Hospital and medical center being built in New Orleans?

Louisiana Treasurer John Kennedy talked about these issues in part 2 of a Bayoubuzz.com interview with attorney and publisher Stephen Sabludowsky.

Kennedy said in the interview that he is not a fan of the Affordable Care Act, or Obamacare because it does not deal with the most difficult problem which is cost of healthcare services and has not been a supporter of the legislation.

How, in the interview Kennedy questions if Jindal is not going to accept the Obamacare provision that would allow all states, including Louisiana to add 400,000 to the Medicaid rolls with the federal government paying for all of it for a period of time, based upon the business plan for the Charity Center in New Orleans, how will the business plan work?

In the interview, Kennedy said, “Whether you agree with his decision or don’t agree with it, if you read the business plan, for the new Charity hospital in New Orleans, it assumes that we will be a part of the Medicaid portion of Obamacare, and if we’re not going to be a part of it, then the numbers, the cash flow analysis for the new hospital, I can tell you, doesn’t work.

I mean, that’s just a fact. Whether you like Obamacare or don’t like it, they built the new hospital on the premise that we would be a part of it. Now what will happen in the future, I don’t know. I don’t know the role, what any factors in this regards will be in the role of in terms of Childrens’ or Touro’s decision, but I read the business plan more times than I care to remember and I will tell you it assume..it basically says, if we do not join the Medicaid portion of Obamacare, this new hospital will go bankrupt.

That’s what it says, whether you agree or disagree, and that’s why I’ve always said we need to be careful here in building something that is too large that it won’t be able to cash flow.

Under the Kaiser Foundation report, they are estimating roughly 400,000 people today in Louisiana who don’t have health insurance, if we had elected to be a part of the Medicaid portion of Obamacare, would be added to the Medicaid roles, the feds would pay 100 percent to 2016 and then after 2016 would pay 90 percent.

Now the governor, he has chosen not to join the Medicaid portion and he is working on a plan for these 400,000 who won’t be on Medicaid but we have not seen the details of the plan yet so it’s hard to comment on it.

We have about 800,000 uninsured people in Louisiana that don’t have Medicaid, they don’t have Medicaid they don’t have any private insurance, my understanding is that under the Obamcare half of those were going to be placed in Medicaid and the other half were going to be allowed to buy the insurance on the insurance exchange and those purchases were going to be subsidized by the federal government.

Now the insurance exchange will continue on, that’s not voluntary on behalf of the states, but Louisiana has made a decision not to join the Medicaid portion of Obamacare and the governor is going to come up with a plan of his own I am told to provide healthcare to those people.

How we will pay for it and what the details are, I don’t have any of that information and I don’t think anybody else does yet.”

Kennedy said he does not know if the legislature will have any input, that the legislature to his knowledge has had no input so far, or will they have more input into the future. Kennedy said, “I don’t know. I have no way of knowing. Unless they, I just don’t know.”

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